Individual
MRS. KATIE M. WIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR
Contact information
Practice address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Mailing address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004457A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200884650
—
IN
Enumeration date
10/11/2007
Last updated
02/06/2013
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